What are the symptoms of cardiovascular syphilis and neurosyphilis?
Nov 29, 2025
Source: Cainiu Health
Dr. Liu Wenmin
Introduction
Cardiovascular syphilis and neurosyphilis are severe manifestations of late-stage syphilis, with diverse symptoms including aortic valve insufficiency, aortic aneurysm, asymptomatic neurosyphilis, meningeal or vascular neurosyphilis, and paralytic dementia. Patients should receive standardized anti-syphilis treatment as early as possible and undergo regular follow-up examinations of cerebrospinal fluid and cardiovascular indicators.
Cardiovascular syphilis and neurosyphilis are severe manifestations of late-stage syphilis, with diverse symptoms including aortic valve insufficiency, aortic aneurysm, asymptomatic neurosyphilis, meningovascular syphilis, and paralytic dementia. A detailed analysis is as follows:
1. Aortic valve insufficiency: Commonly seen in patients with cardiovascular syphilis, early stages may present no obvious discomfort. As the disease progresses, symptoms such as palpitations and shortness of breath appear, worsening with physical activity. In severe cases, paroxysmal nocturnal dyspnea and orthopnea may occur. Some patients experience chest pain related to myocardial ischemia caused by aortic regurgitation.
2. Aortic aneurysm: Caused by destruction of the aortic wall by *Treponema pallidum*, leading to aneurysmal dilation. Symptoms vary depending on location. Thoracic aortic aneurysms may compress the sternum or ribs, causing persistent chest pain; abdominal aortic aneurysms may lead to lower back pain. Rupture of the aneurysm can result in fatal internal bleeding.
3. Asymptomatic neurosyphilis: Patients show no obvious subjective symptoms, but cerebrospinal fluid (CSF) examination reveals abnormalities, indicating that the central nervous system has already been invaded by *Treponema pallidum*. This condition is easily overlooked and, if not treated promptly, may progress to more severe forms of neurosyphilis.
4. Meningovascular syphilis symptoms: Often presents with headache and vomiting. Some patients may experience seizures, limb weakness, or sensory disturbances. Symptoms depend on the affected area; involvement of cerebral blood vessels may lead to cerebral infarction, manifesting as slurred speech, hemiplegia, and other neurological deficits.
5. Paralytic dementia symptoms: Characterized primarily by mental and intellectual impairment. Early signs include memory loss and poor concentration, gradually progressing to impaired judgment and emotional disturbances. In later stages, patients may develop personality changes and behavioral disorders, severely affecting daily functioning.
Patients should receive timely and standardized anti-syphilis treatment and undergo regular follow-up evaluations of cerebrospinal fluid and cardiovascular parameters. During treatment, maintaining a regular lifestyle, avoiding excessive fatigue, and eating a balanced diet to enhance immune resistance are recommended.
